Anderson, Michael

aCAMA / El DREDGE & FILL J
GENERAL PERMIT Previous permit #
(New E]Moclification ElComplete Reissue ElPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources -7
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
LEI Rules attached.
Applicant Name I itj Project Location: County
'Address 1,.,; 16 ri !) /V Street Address/ State Road/ Lot #(s)
City 1,vc', State _,.
Phone # Fax #
Authorized Agent 01'` i Y,
Affected OCW ,qEW" A� PTA E3 ES 0 PTS
AEC(s): 0 OEA El HHF 01H 0 UIBA 0 N/A
El PWS: 0FQ
ORW: yes PNA yes Prit.Hab. yes
Subdivision
Cityj",
t ZIP
Phone # River Basin (Jx
�,
Adj. Wtr. Bodyt' el `.1d 1&t /man /unkjn
Closest Maj. Win Body
Type of Project/ Activity v,,S 1-r r
(Scale:
10
Pier (dock) length -� I
Platform(s) "I / . "�`I
Finger pier(s)­___L_
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other 441
Shoreline Length
4�1i-
�SAV: not sure
yes 11111no�
'Sandbags: notsure
yes no
'Moratorium: n/a
yes tqo�;
Photos:
yes not
Waiver Attached:
yes;' no
A building permit may be requires
Notes/ Special Conditions
NEEMENEEMENEEMENSE
so
NEENEENEENNEEN
mom
E
OEM
NNNN
NNNN
000111MM01100
MEN
mom
11
11INNO
Ir.....
NNE
MEN
r
Mal
RNMENNENEE
NNONNIMENNNONE11
OMEN
MEMENNON
NNEENNNNEMEME
OMEN
MENEEMENEMEMERNME
MENNEEMENEENE
by: t"i i if El See note on back regarding River Basin rules.
1 1`7 -tl Vi 0 !Q 1 J,
,(gent or Applicant Printed Name Permit Officir'g Signature
Signature' **Please read compliance statement on back of permit" Issuing Date'
Application Fee(s) Check # Local Planning jurisdiction
Expiration Date
Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null andvoid.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowners).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date ppRIL $, 2014
Name of Property Owner Applying for Permit:
MICHAEL J. AND BARBARA B. ANDERSON
Mailing Address:
211 DRUMMOND DRIVE
RALEIGH, NC 27609
I certify that I have authorized (agent) BOGUE BANKS MARINE CONSTRUCTIOtio act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) DOCK ADDITION ,
at (my property located at) 105 COTTONWOOD COURT, PINE KNOLL SHORES, NC
This certification is valid thru (date) OCTOBER 10, 2014
�; :-��?f.✓ � 1;'.'1���%� S!'1c-`�WGttii-�ux ��^�u�ut:'k'�yt y— �- %ti.
Property Owner Signature Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Michael J. and Barbara Z. Anderson
's
property Lot 18, 105 Cottonwood Court v Pi (Name of Property Owner
ro located at Pine Kno:._ Shores, C
(Address, Lot, Block, Road, etc.)
on Bogue Sound I in Pine Knoll Shores N
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location. ,�
""T� �� I'ro objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(lndivldual proposing devalopment must fiH in descripticn below or attach a site drawing)
See attached diagram for five feet by twenty feet addition to norm west side
of existing dock.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse. lift. or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
It
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
S'-^,
Signature Micliael J. Anderson
Barbara Z. Anderson
Ptint or Type Name
211 Drummond Drive
Mailing Address
Raleigh, NC 27609
Cdty tate&Jp
Telephone Number
Date
n)
Signature Frank T. Batten
Florence P. Batten
Pnnt or Type Name
.S547 C Packhouse Road
Mailing Address
Wilson, NC 27896
CitvlStatelZip
1Sy - .>-�/--
Telephone Numbe,
Date
(Revised 61!W012;

h
EXIST NC OCICK
U=rYM10h
Gl
7b �xs�r ,Ddcl�
M,411:My r` ' i
! trA �
s. o0
AMC
DOCK
-X)STINC Qoq

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to `+ichael and Barbara Z. And e-:szn
s
(Name of Property Owner_
property located at Lot 18, 105 Cottonwoce Court, Pine :gin:_. Snores,Ni.
,(Address, Lot, Block, Road, etc.)
on Bogue Sourd it ?i +e -c:' 5 -ores N
(Waterbody) , (City/Town and/or County)
applicant has described to me. as shown' below. tie deve oo-e— or000sed a: the above
V t
VA-64✓ I have no objection to this proposal.
I have objections to th's proposa;
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing;
See attached diagram for fi.,e feet twenty feet add_t_---n tc nert- west side
Of existine dock.
WAIVER SECTION
I understand that a pier. dock. mooring pilirgs breakwater boathouse. 'if.. or groin must be set
back a minimum distance of 15' from my area of nparian access +.:nless :valved by me !if you
wish to waive the setback. you must initial the appropriate blank below
do w;sh tc waive the 15' setback 'equ!re-le-
I do not wish to waive the 15'
(Property Owner niorrr>iati n)
Signature Micha J. Anderson
Barbara Z. Anderson
Print or Type Name
211 Drummond Drive
Mailing Address
Raleixh, NC 27609
CitvIState2ic
'eleohone Number
Date
Property Owner Information)
i'vw}c i:; ,•e 6 t e tin
Mary Carlyle V. B
wont �r 7vc-a 'me
PO Boy: B44
Mai,J.,7G arfr+rro
G'S Moreheac lefty, NC 28537
Pe:'vse� 5/'$I2012

• . M
pRapns6o 4VOrzr4,n
125 maxis -rt4, .Pe<-kt
VHY;
uwtviStm
. ci
W Dock
�7(1SINC QOCK